Paul Johnson Physical Therapy, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PAUL JOHNSON PHYSICAL THERAPY, INC

Practice address

3033 Cleveland Ave.
205
Santa Rosa, CA 95403

Phone

(707) 542-8313

NPI assigned

Apr 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Shelby Renee Brown

Title

Business Office Manager

Phone

(707) 542-8313

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• STAR, Sports Training and Rehabilitation Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346460417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 CLEVELAND AVE.",
            "address_2": "205",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-542-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 CLEVELAND AVE.",
            "address_2": "205",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-542-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL JOHNSON PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "707-542-8313",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "ZZZ64164Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STAR, Sports Training and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria B. Patten, DO
• Jenny D Patterson-Kerr
• Delilah Patterson, CRNA
• Jana Lee Patterson, OTR/R
• Marie Patterson
• Paul V Sejud DMD PC
• Colleen Paul
• Jane S. Paul
• Jean Marie Pauley, BIRTH DOULA
• Glenn Dale Paulson, RASI

• Physical Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.